- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04442997
Use of Cesarean Birth at Private Health Facilities in Lilongwe and Blantyre, Malawi
Study Overview
Status
Conditions
Detailed Description
Background:
Cesarean birth is the most commonly performed surgery in the world. It is a major abdominal procedure that can save maternal and perinatal lives when properly indicated, but when performed without medical necessity, is associated with adverse outcomes. Global cesarean birth rates are increasing, but there has been a less pronounced rise in sub-Saharan Africa (SSA) where rates tend to be below 5.0%. However, in Sub-Saharan Africa (SSA) and other low- and middle-income countries (LMIC), there is a recognition that significant in-country disparities in the use of cesarean birth exist. Rates are higher in urban settings, and there is evidence that they are higher in private versus public facilities.
Objective and Aims:
The main objective of this prospective, cross-sectional, observational study is to observe the use of cesarean birth at three private health facilities in urban Malawi by the end of the study. This will be achieved by getting an understanding of the current delivery practices and patient characteristics, as well as associated outcomes of women who choose to deliver at these private facilities in order to understand how and under what circumstances the surgery is being used.
Aim 1: Observe prevalence of and indications for cesarean birth in three private health facilities in urban Malawi in the overall cohort and in ten mutually exclusive subgroups defined by the WHO-endorsed Robson Classification for cesarean birth
Aim 2: Determine risk factors associated with cesarean birth among Robson subpopulations of women at study sites, and the distribution of adverse pregnancy outcomes across those subgroups
Aim 3: Identify target modifiable risk factors or areas for potential quality improvement or prospective research studies to optimize the use of cesarean birth within these facilities that may have generalizable implications
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Blantyre, Malawi
- Mwaiwathu Private Hospital
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Lilongwe, Malawi
- Area 18 Medi Clinic - Asamala Health Services
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Lilongwe, Malawi
- Good Hope Private Clinic
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- ADULT
- OLDER_ADULT
- CHILD
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Pregnancy
- Admitted for delivery or observation
Exclusion Criteria:
-
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Rate of participants using cesarean section delivery as assessed by survey questionnaires
Time Frame: Hospital admission to discharge, about 3-4 days
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Hospital admission to discharge, about 3-4 days
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Types of indications for cesarean birth
Time Frame: Hospital admission to discharge, about 3-4 days
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Hospital admission to discharge, about 3-4 days
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Types of adverse pregnancy outcomes among participants using cesarean section
Time Frame: Hospital admission to discharge, up to 1 week
|
The types of adverse pregnancy outcomes reported among participants with cesarean section deliveries will be assessed via survey questionnaires.
Data will be reported by population subgroup.
Population subgroups will be defined by the World Health Organization-endorsed Robson Classification for Cesarean Birth
|
Hospital admission to discharge, up to 1 week
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Types of risk factors for Cesarean birth
Time Frame: Hospital admission to discharge, about 3-4 days
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The types of modifiable risk factors for cesarean birth reported among participants that use cesarean section delivery will be assessed via survey questionnaires
|
Hospital admission to discharge, about 3-4 days
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Margo Harrison, MD, MPH, University of Colorado - Anschutz Medical Campus
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
- 20-0468
- NICHD/K12 HD001271-21 (OTHER_GRANT: NICHD)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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